Management of Acute Non-Traumatic Intradural Spinal Hematoma Associated With Oral Anti-Coagulant and Anti-Aggregant Therapy: Case Report and Review of Literature


Gurcay A. G. , Gurcan O., Kazanci A., Goker T., Turkoglu O. F. , Bavbek M.

JOURNAL OF NEUROLOGICAL SCIENCES-TURKISH, cilt.32, ss.231-236, 2015 (SCI İndekslerine Giren Dergi) identifier

  • Cilt numarası: 32 Konu: 1
  • Basım Tarihi: 2015
  • Dergi Adı: JOURNAL OF NEUROLOGICAL SCIENCES-TURKISH
  • Sayfa Sayısı: ss.231-236

Özet

Most of the non-traumatic spinal hematomas are epidural hematomas and reported less than 1% in literature. Intra-dural non-traumatic spinal hematomas are even more rare pathologies. A 55-years-old man admitted with the complaints of vertigo and left hemi-hypoesthesia. MRI findings revealed left cerebellar, left parieto-occipital diffusion restriction and dissection of left cervical segment of internal carotid artery and patient was treated with anticoagulant and anti-aggregant therapy. During anticoagulant and anti-aggregant therapy sudden onset paraparasia with motor strength 2/5 was developed. Urgent throco-lumbar MRI revealed intra-dural acute hematoma at T12-L5 levels. The patient immediately underwent decompressive T11-T12-L1-L2-L3-L4-L5 total laminectomy, intra-dural rigid hematoma drainage and posterior instrumentation with duraplasty. The patient was discharged with motor strength 4/5 bilaterally on the 15th day of operation. To our knowledge present case is the longest segmental intradural non-traumatic spinal hematoma in the literature that underwent decompressive and stabilization surgery. Non-traumatic spinal intradural hematomas (NTSIDH) are extremely rare. Urgent decompressive surgery is gold standard for patients with progressive neurologic deficits.